Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-10T09:42:02.853Z Has data issue: false hasContentIssue false

Chapter 5 - The Ever-changing Role of the Mental Health Care Professional in Transgender Healthcare

from Section A - Contextual Transgynecology

Published online by Cambridge University Press:  22 December 2022

By
Gunter Heylens  and
Els Elaut
Edited by
Mick van Trotsenburg ,
Rixt A. C. Luikenaar  and
Maria Cristina Meriggiola
Mick van Trotsenburg
Affiliation:
Sigmund Freud PrivatUniversität, Wien
Rixt A. C. Luikenaar
Affiliation:
Rebirth Health Center, Utah
Maria Cristina Meriggiola
Affiliation:
Università di Bologna
Get access

Summary

This chapter critically illuminates the role, tasks, and challenges of mental health professionals (MHPs) in transgender care and cites relevant literature. Various models of professional–client relationships are presented. Realistic and unrealistic expectations of somatic-oriented professionals about the diagnostic and preparatory process by MHPs are discussed in detail and a critical appraisal of referral letters is included. Also, meaning and necessity of cooperation between MHPs and somatic-oriented medical healthcare professionals are emphasized.

Keywords

mental health careassessmentcare models
Type
Chapter
Information
Context, Principles and Practice of TransGynecology
Managing Transgender Patients in ObGyn Practice
 , pp. 32 - 38
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Byne, W, Karasic, DH, Coleman, E, et al. Gender dysphoria in adults: an overview and primer for psychiatrists. Transgender Health 2018;3:57–70.Google Scholar
Gijs, L, van der Putten-Bierman, E, De Cuypere, G. Psychiatric comorbidity in adults with gender identity problems. In Kreukels, BPC, Steensma, TD, de Vries, ALC, Eds. Gender Dysphoria and Disorders of Sex Development: Progress in Care and Knowledge. New York: Springer, 2013, pp. 255–276.Google Scholar
de Freitas, LD, Léda‐Rêgo, G, Bezerra‐Filho, S, Miranda‐Scippa, Â. Psychiatric disorders in individuals diagnosed with gender dysphoria: a systematic review. Psychiatry Clin Neurosci 2020;74:99–104.Google Scholar
Murad, MH, Elamin, MB, Garcia, MZ, et al. Hormonal therapy and sex reassignment: a systematic review and meta-analysis of quality of life and psychosocial outcomes. Clin Endocrinol 2010;72:214–231.Google Scholar
Bustos, VP, Bustos, SS, Mascaro, A, et al. Regret after gender-affirmation surgery: a systematic review and meta-analysis of prevalence. Plast Reconstr Surg Glob Open 2021;9(3):e3477.CrossRefGoogle ScholarPubMed
Turban, JL, Loo, SS, Almazan, AN, Keuroghlian, AS. Factors leading to “detransition” among transgender and gender diverse people in the United States: a mixed-methods analysis. LGBT Health 2021;8(4):273–280.CrossRefGoogle ScholarPubMed
Witcomb, GL, Bouman, WP, Claes, L, et al. Levels of depression in transgender people and its predictors: results of a large matched control study with transgender people accessing clinical services. J Affect Disord 2018;235:308–315.CrossRefGoogle ScholarPubMed
Marshall, E, Claes, L, Bouman, WP, et al. Non-suicidal self-injury and suicidality in trans people: a systematic review of the literature. Int Rev Psychiatry 2016;28:58–69.CrossRefGoogle ScholarPubMed
Zucker, K, Lawrence, A, Kreukels, BK. Gender dysphoria in adults. Ann Rev Clin Psychol 2016;12:217–247.Google Scholar
Dhejne, C, Van Vlerken, R, Heylens, G, Arcelus, J. Mental health and gender dysphoria: a review of the literature. Int Rev Psychiatry 2016;28:44–57.CrossRefGoogle ScholarPubMed
Colizzi, M, Costa, R, Todarello, O. Dissociative symptoms in individuals with gender dysphoria: is the elevated prevalence real? Psychiatry Res 2015;226:173–180.CrossRefGoogle ScholarPubMed
Cohen, J, Blasey, C, Barr Taylor, C, Weiss, BJ, Newman, MG. Anxiety and related disorders and concealment in sexual minority young adults. Behav Ther 2016;47:91–101.Google Scholar
Mereish, EH. Substance use and misuse among sexual and gender minority youth. Curr Opin Psychol 2019;30:123–127.Google Scholar
Dhejne, C, Lichtenstein, P, Boman, M, et al. Long-term follow-up of transsexual persons undergoing sex reassignment surgery: cohort study in Sweden. PLOS ONE 2011;6(2): e16885.Google Scholar
Wiepjes, CM, den Heijer, M, Bremmer, MA, et al. Trends in suicide death risk in transgender people: results from the Amsterdam Cohort of Gender Dysphoria study (1972–2017). Acta Psychiatr Scand 2020;6:486–491.Google Scholar
Costa, R, Colizzi, M. The effect of cross-sex hormonal treatment on gender dysphoria individuals’ mental health: a systematic review. Neuropsychiatr Dis Treat 2016;12:1953–1966.Google ScholarPubMed
Kristensen, TT, Christensen, LL, Frystyk, J, et al. Effects of testosterone therapy on constructs related to aggression in transgender men: a systematic review. Horm Behav 2021;128:104912.Google Scholar
Matthys, I, Defreyne, J, Elaut, E, et al. Positive and negative affect changes during gender-affirming hormonal treatment: results from the European Network for the Investigation of Gender Incongruence (ENIGI). J Clin Med 2021;10(2):296.Google Scholar
Ruppin, U, Pfäfflin, F. Long-term follow-up of adults with gender identity disorder. Arch Sex Behav 2015;44:1321–1329.CrossRefGoogle ScholarPubMed
De Cuypere, G, Vercruysse, H. Eligibility and readiness criteria for sex reassignment surgery: recommendations for revision of the WPATH standards of care. Int J Transgend 2009;11(3):194–205. https://doi.org/10.1080/15532730903383781CrossRefGoogle Scholar
Coleman, E, Bockting, W, Botzer, M, Cohen-Kettenis, PT. Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7. Int J Transgend 2012;13(4):165–232.CrossRefGoogle Scholar
Ashley, F. Gatekeeping hormone replacement therapy for transgender patients is dehumanizing. J Med Ethics 2019;45:480–482.CrossRefGoogle Scholar
Cavanaugh, T, Hopwood, R, Lambert, C. Informed consent in the medical care of transgender and gender-nonconforming patients. AMA J Ethics 2016;18(11):1147–1155.Google ScholarPubMed
Reisner, S, Bradford, J, Hopwood, R, et al. Comprehensive transgender healthcare: the gender affirming clinical and public health model of Fenway health. J Urban Health 2015;92(3):584–592.CrossRefGoogle Scholar
Emmanuel, EJ, Emmanuel, LL. Four models of the physician-patient relationship. JAMA 1992;267(16):2221–2226.CrossRefGoogle Scholar
Gerritse, K, Hartman, LA, Bremmer, MA, Kreukels, BPC, Molewijn, BC. Decision-making approaches in transgender healthcare: conceptual analysis and ethical implications. Medicine, Health Care and Philosophy 2021 (online). https://doi.org/10.1007/s11019–021-10023-6Google Scholar
Bordin, ES. The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research and Practice 1979;16(3):252–260.Google Scholar
Horvath, AO, Del Re, AC, Flückiger, C, Symonds, D. Alliance in individual psychotherapy. In Norcross, JC, Ed. Psychotherapy Relationships that Work: Evidence-based Responsiveness. Oxford: Oxford University Press, 2011, pp. 25–69. https://doi.org/10.1093/acprof:oso/9780199737208.003.0002CrossRefGoogle Scholar
Motmans, J, Wyverkens, E, Defreyne, J. Being transgender in Belgium. Ten years later. Brussels: Institute for the Equality of Women and Men, 2017. Available from: https://igvm-iefh.belgium.be/sites/default/files/118_-_leven_als_transgender_persoon_in_belgie.pdfGoogle Scholar
European Union Agency for Fundamental Rights. EU-LGBTI II: a long way to go for LGBTI equality. Luxembourg: Publications Office of the European Union, 2020. Available from: https://fra.europa.eu/en/publication/2020/eu-lgbti-survey-resultsGoogle Scholar
Health4LGBTI. Qualitative research. Focus groups studies with LGBTI people and health professionals. Final overview report of the outcomes of the focus groups: European Union, 2017. Available from: https://ec.europa.eu/health/social_determinants/projects/ep_funded_projects_en#fragment2Google Scholar
Dewey, JM, Gesbeck, MM. (Dys)functional diagnosing: mental health diagnosis, medicalization, and the making of transgender patients. Humanity Soc 2017;41(1):37–72.Google Scholar
Schulz, SL. The informed consent model of transgender care: an alternative to the diagnosis of gender dysphoria. J Humanist Psychol 2018;58(1):72–92.CrossRefGoogle Scholar
MacKinnon, KR, Grace, D, Ng, SL, Sicchia, SR, Ross, LE. “I don’t think they thought I was ready”: how pre-transition assessments create care inequities for trans people with complex mental health in Canada. Int J Mental Health 2020;49:56–80.Google Scholar
Mackenzie, C. Relational autonomy, normative authority and perfectionism. J Soc Philos 2008;39(4):512–533.Google Scholar
Wiepjes, CM, Nota, NM, de Blok, CJM, et al. The Amsterdam cohort of gender dysphoria study (1972–2015): trends in prevalence, treatment, and regrets. J Sex Med 2018;15(4):582–590.Google Scholar
Karasic, DH, Fraser, KL. Multidisciplinary care and the standards of care for transgender and gender nonconforming individuals. Clin Plast Surg 2018;45:295–299.Google Scholar
Ducheny, K, Hendrickx, ML, Keo-Meier, CL. TGNC-affirming interdisciplinary collaborative care. In Singh, A and Dickey, IM, Eds. Affirmative Counseling and Psychological Practice with Transgender and Gender Nonconforming Clients. Washington, DC: American Psychological Association, 2017, pp. 69–93.Google Scholar
McIntosch, CA. Interdisciplinary care for transgender patients. In Eckstrand, KL and Ehrenfeld, JM, Eds. Lesbian, Gay Bisexual, and Transgender Healthcare. Switzerland: Springer International Publishing, 2017, pp. 339–349.Google Scholar
Hembree, WC, Cohen-Kettenis, P, Delemarre-van de Waal, HA, et al. Endocrine treatment of transsexual persons: an endocrine society clinical practice guideline. JCEM 2009;94(9):3132–3154.CrossRefGoogle ScholarPubMed
Bouman, WP, Schwend, AS, Motmans, J, et al. Language and trans health. Int J Transgend 2017;18(1):1–6.Google Scholar
Elwyn, G, Frosch, D, Thomson, R, et al. Shared decision making: a model for clinical practice. J Gen Intern Med 2012;27(10):1361–1367.Google Scholar
Coulter, A. Shared decision making: everyone wants it, so why is it not happening? World Psychiatry 2017;16(2):117–118.CrossRefGoogle Scholar
van de Grift, T, Mullender, MG, Bouman, MB. Shared decision making in gender-affirming surgery. Implications for research and standards of care. J Sex Med 2018;15:813–815.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×